Unknown Individual – Legal Medicine, NPI 1104812619
Legal Medicine
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
23, Professional Park Drive, Clarksville, Johnson County, Arkansas, 72830, United States
CLARKSVILLE, AR 728304432
Phone: (479) 754-4721
Fax: (844) 584-4213
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $65.
Total Amount is formed as General ($65) + Research ($0) + Ownership ($0) = $65.
Last reported payment date: 2024-11-11 • Largest payer in this snapshot: Abbott Laboratories ($37).
Total Amount
$65
General + Research + Ownership
Payments
3
Total payment records
General Amount
$65
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $37 |
| Almatica Pharma LLC | $28 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 72830)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | AR | 83036 | Hemoglobin A1C level | 118 | 68 |
| FAMILY MEDICINE | AR | 85610 | Blood test, clotting time | 84 | 15 |
| FAMILY MEDICINE | AR | 94060 | Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration | 17 | 16 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | AR | |
| Family Practice | AR | |
| Family Practice, Emergency Medicine | AR |
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